After a long Summer of writing, I am really happy to tell you that my latest AIMS book, Group B Strep Explained, is now rolling off the presses! Already available to pre-order from AIMS website, the book costs £8 and has been written for women who need to make decisions about GBS screening and treatment, and for anyone who wants to better understand this area. This is a complex topic in which the evidence and the issues are not clear-cut, and we hope that the book will help women and those who care for them.
After an introductory section which describes the issues and the background (which means you don’t need any prior knowledge in order to make sense of it), I look at the different kinds of screening that are used in different areas of the Western world:
“Two very different approaches to screening emerged, and both of them remain quite crude. A good screening test will identify as many of the people who have a particular problem as possible, while not identifying too many people as being at risk if they don’t have the problem. These elements are referred to as sensitivity and specificity. Both of the current approaches to screening for GBS disease are reasonably good (although not perfect) at picking up most of the people who are at risk (that is, they are quite sensitive) but both pick up very high numbers of people who are not at risk (so they are not very specific). Given that the consequence of being defined as ‘at risk’ is to be offered antibiotics in labour – which, if you decide to have them, means having a cannula in your arm and (usually) being in hospital, and having antibiotics that have their own associated risks – this is by no means an ideal situation.” (Wickham 2014)
I have also detailed which women are perceived to be at risk within the UK, and looked at who will be offered antibiotics in labour, and who won’t. Throughout the book, I have taken into account that not all women will want to follow the guidance, for lots of different reasons, and have addressed questions around how to decline screening and treatment that you do not want as well as how to get screening and treatment if you do want this but it is not on offer locally. I have also looked at the evidence that exists in relation to different elements of this debate because, as we know, research findings are open to interpretation and there is not always a perfect correlation between evidence and guidelines (sometimes for good reason).
In other parts of the book, I look at the different kinds of testing that are used, and consider which is more accurate. I discuss the pros, cons, implications, side effects and reality of having antibiotics, and of how having screening and/or treatment for GBS can affect other birth-related decisions; something that I don’t think people always realise. I have, before anyone asks, gathered together what I can find on GBS and waterbirth and looked at alternatives to antibiotics (though there really isn’t much evidence, and we need much more research into this). I’ve included a whole section on FAQs so that women who are in a hurry can turn to that section and find a shorter answer rather than having to read the whole book again. And, knowing that not every woman wants GBS screening and treatment, I have looked at ongoing options once the baby is born, including signs of infection in babies – or, what to look for if you decline treatment.
“There are no rights and wrongs here. The important thing is to weigh up the information, consider your own circumstances, beliefs and feelings and to make the best decision that you can for your own personal situation.” (Wickham 2014).
I really hope this book will help women and their families, as well as those caring for women who want an update on the evidence / issues. There is so little out there on this, and many women have expressed a need to AIMS for such a book. The AIMS committee and several other people have worked really hard on this with me – thank you all – and I am delighted that quite a few of them will be with me at the launch event for the book, which will take place in Bristol on the evening of Wednesday 26th November, so if you’re coming to that, I’ll see you there!